Use OF NBI for the assessment of clinical signs of rhino-pharyngo-laryngeal reflux in pediatric age: Preliminary results

Galli, Jacopo; Meucci, Duino; Salonna, Giampiero; Anzivino, Roberta; Giorgio, Valentina; Trozzi, Marilena; Settimi, Stefano; Tropiano, Maria Luisa; Paludetti, Gaetano; Bottero, Sergio

doi:10.1016/j.ijporl.2019.109733

Cited by 12 publications

(15 citation statements)

References 31 publications

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“…that NBI provides evidence of LPR signs not detected using white light [7]. In 2020 our group performed work to evaluate the possible use of NBI for an integrated endoscopic examination in LPR diagnosis in adult patients.…”

Section: Galli Et Al Studied Nbi For Rhino-pharyngolaryngeal Reflux I...mentioning

confidence: 99%

“…At present, in oncological diseases, narrowband imaging (NBI) has been introduced for an early diagnosis, but it has also been described as useful for classifying benign lesions. Galli et al studied NBI for rhinopharyngolaryngeal reflux in pediatric patients and observed that NBI provides evidence of LPR signs not detected using white light [ 7 ]. In 2020, our group performed work to evaluate the possible use of NBI for an integrated endoscopic examination in LPR diagnosis in adult patients.…”

Section: Introductionmentioning

confidence: 99%

“…RFS, according toBelafsky et al [27] evidenced an improvement during follow-up of LPR patients treated with PPI therapy with an excellent inter and intra-observer reproducibility.However, in the last years, Narrow Band Imaging (NBI) endoscopic evaluation has been performed not only in the oncologic ENT field, but also for the study of benign ENT lesions. Galli et al analyzed the effect of LPR in children using NBI to study cobblestone aspects of the hypopharyngeal mucosa, phlogosis of the tonsillar crypts and adenoid surface, hyperemia and hypervascularization of subglottic and tracheal mucosa[7].In 2020, Pace et al[8] performed a study to evaluate the comparison between LPR studied with withe light endoscope and NBI ones. Moreover, they tried to define an NBI classification system to classify the grade of LPR disease.…”

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confidence: 99%

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Osa patients vs laryngopharyngeal reflux disease: Non-invasive evaluation with NBI and pepsin detection in tears

Pace¹,

Rossetti²,

Milani³

et al. 2022

Bosn J of Basic Med Sci

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Obstructive sleep apnoea (OSA) and laryngopharyngeal reflux disease (LPR) are two common diseases that lower patients' quality of life. OSA is defined by cyclic events of airflow obstruction that occur during sleep, while LPR is characterized by upper airway inflammatory signs and symptoms due to the return of gastroduodenal gaseous and liquid elements. pH-metry is the gold standard in LPR diagnosis, but considering its invasiveness among other negative traits, questionnaires that catalog symptoms and signs of the disease such as Reflux Symptoms Index (RSI) and Reflux Finding Score (RFS) are preferred. Moreover, LPR can be evaluated by testing the presence of pepsin in tears, and Narrow Band Imaging (NBI) has been introduced for the early diagnosis of larynx oncological disease. This paper aims to test whether LPR is more frequent in OSA patients than in control ones, performing a non-invasive protocol composed of RSI, RFS test (with light vs. NBI techniques), followed by pepsin detection in tears. 68 LPR patients were enrolled in the study (45 with OSA and 23 without OSA). A strong linear relationship between Apnea-Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) was found, and patients who presented pepsin in tears had higher values of AHI and ODI in comparison to patients without it. Pathological RFS and NBI showed higher values of AHI and ODI in comparison to the control group. Furthermore, pathological RSI showed higher values of AHI and ODI in comparison to the control group. In conclusion, this diagnostic combined non-invasive protocol may be a good method to perform an early diagnosis of LPR.

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Section: Galli Et Al Studied Nbi For Rhino-pharyngolaryngeal Reflux I...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Osa patients vs laryngopharyngeal reflux disease: Non-invasive evaluation with NBI and pepsin detection in tears

Pace¹,

Rossetti²,

Milani³

et al. 2022

Bosn J of Basic Med Sci

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“…NBI already showed its usefulness in early diagnosis of neoplastic lesions of the UADT [2][3][4][5] and in 2011, Ni et al [6] proposed a classification based on the modification of mucosal vascularization observed with NBI allowing the in vivo differentiation of non-malignant and malignant laryngeal lesions. Furthermore, NBI is widely used for inflammatory pathologies of the head and neck in all age groups [7,8]. However, a precise diagnosis of mucosal lesions remains challenging and recent studies aimed at assessing its diagnostic accuracy in laryngeal lesions [9,10].…”

Section: Introductionmentioning

confidence: 99%

Role of Narrow Band Imaging Technology in the Diagnosis and Follow up of Laryngeal Lesions: Assessment of Diagnostic Accuracy and Reliability in a Large Patient Cohort

Galli

Settimi

Mele

et al. 2021

JCM

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Background: The aim of this study was to assess diagnostic accuracy and reliability of narrow band imaging (NBI) in the differential diagnosis of laryngeal premalignant lesion, early cancers and recurrences. Material and methods: We enrolled 231 patients who underwent endoscopic examination with white light endoscopy (WLE) + NBI and divided them into two groups, group A, without previous radiochemotherapy and group B, with previous radiochemotherapy. When indicated, we performed surgical biopsies to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood of endoscopic examination comparing WLE alone and WLE + NBI. Results: A positive NBI lesion, compared with a negative NBI lesion, had a 29.68 (group A) and 13.96 (group B) times higher probability to be histologically positive (i.e., confirmed) compared with WLE alone improving the diagnostic accuracy. In group A, the NBI mode showed excellent sensitivity (95.0%), which was higher than WLE 2 mode (77.5%). However, the greatest differences were recorded regarding specificity (96.8% vs. 40.6%). In group B, both NBI alone and WLE + NBI mode showed a 94.1% specificity compared with WLE alone, which had a maximum specificity of 85.3%. The mode comparison between NBI and WLE in both groups showed a statistically significant difference, with p-values <0.0001. Conclusions: NBI represents a reliable technology in challenging situations, especially in the context of post-radiotherapy or post-surgical mucosal changes showing a high NPV. NBI could reduce the number of unnecessary biopsies related to increased microvascular anomaly revelation, which could help to identify early-stage lesions suitable for minimally invasive surgery and, consequently, decrease hospital admissions.

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“…When reflux occurs into the throat, laryngeal mucosa cells may be damaged [18] . Recent studies have shown that pepsin can be used as a diagnostic marker of LPR [19,20] .…”

Section: Introductionmentioning

confidence: 99%

H.pylori and Pepsin as a Putative Risk Factors in Laryngeal Cancer Patients.

Mahmoud

Kamel

Hamed

et al. 2020

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Background: Laryngeal cancer constitutes 26-30% of all head and neck malignant tumors. Chronic stimulation by acid reflux may lead to a malignant change in the laryngopharyngeal mucosa. Pepsin assay could be a rapid, sensitive, and specific diagnostic marker of extra-esophageal reflux (EES). Helicobacter pylori is involved in the pathogenesis of peptic ulcer, and gastric carcinoma with growing interest in the presence of Helicobacter pylori in the upper aerodigestive tract. Aim: The aim of the study is to confirm the role of H.pylori and pepsin as risk factors in laryngeal cancer patients. Patients and Methods: Seventy-five patients were enrolled in this study, and divided into 3 groups; Group (A) 32 patients with suspected laryngeal malignancy. Group (B) 20 patients with benign laryngeal lesions. Group (C) 22 patients free from laryngeal disease, scheduled for non-laryngeal surgery. All patients were subjected to laryngo-pharyngeal lavage (LPL) using sterile water, before starting the surgical procedure and was analyzed for detection of Pepsin an H. Pylori, also culture for H. Pylori was done. Results: Strong positive association exist between H. pylori and Pepsin and occurrence of laryngeal carcinoma, while there was no statistically significant relationship with occurrence of a benign laryngeal lesions. Conclusion: GER is a risk factor or co-carcinogen in the pathogenesis of laryngeal carcinoma and not considered as a risk factor for benign laryngeal lesions. H. pylori culture and Pepsin assay in LPL can be used as non-invasive tool for detection of GER.

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Use OF NBI for the assessment of clinical signs of rhino-pharyngo-laryngeal reflux in pediatric age: Preliminary results

Cited by 12 publications

References 31 publications

Osa patients vs laryngopharyngeal reflux disease: Non-invasive evaluation with NBI and pepsin detection in tears

Osa patients vs laryngopharyngeal reflux disease: Non-invasive evaluation with NBI and pepsin detection in tears

Role of Narrow Band Imaging Technology in the Diagnosis and Follow up of Laryngeal Lesions: Assessment of Diagnostic Accuracy and Reliability in a Large Patient Cohort

H.pylori and Pepsin as a Putative Risk Factors in Laryngeal Cancer Patients.

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